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KCE Reports 113 Volume Outcome 87
5.4.5 Definition of outcomes
5.4.5.1 Mortality
Table 5.40 shows that in-hospital and approximate 30-day mortality is 5.6% after colon
cancer surgery (148 deaths). Mortality 1 year after surgery is 18.0%. After 2 years it is
28.2%. Mean survival time (median not defined) was 27 months (not visible in Table
5.40).
Table 5.40 also shows that 2-year mortality after surgery is higher with patients
diagnosed with a cancer of the rectosigmoid junction (4310%) in comparison with
patients suffering from a colon cancer (27.4%). These differences confirm the necessity
to add the principal diagnosis to the risk adjustment.
Table 5.40: Colon Cancer surgery: Mortality results
Number Number % Survival
deaths deaths
In-hospital and approximate 30-day mortality 2658 148 5.57
1-year mortality 2658 479 18.02 81.98
2-year mortality
2-year mortality in function of principal diagnosis:
2658 750 28.22 71.78
153 Malignant neoplasm of colon 2521 691 27.41 72.59
1540 Malignant neoplasm of rectosigmoid
junction
137 59 43.07 56.93
Figure 5.18 shows how survival improves with decreasing disease stage. Patients with
stage 3 and 4 disease have the worst survival curves while stage 1 and 2 patients have
the best survival. Patients with unknown disease stage are in between these two groups.
Figure 5.18: Colon cancer surgery: Survival curve by stage
X means stage missing.
Because of lack of reliable data on complications, all analyses on the volume-outcome
association are limited to 2-year mortality rate. This implies that additional outcome
measures such as postoperative rate of stoma, infection and anastomotic leakage, which
are listed in Table 2.1 (page 16), are not analyzed in this report.